Life expectancy for black Americans is about 10% less than for whites. The leading cause of excessive mortality in older blacks is cardiovascular disease which may be largely due to disproportionately high rates of hypertension in older blacks. Conventional antihypertensive drug therapies are frequently associated with adverse effects on quality of life (QL) and low compliance rates, especially in elderly minority populations. Several lines of research have implicated chronic socio-environmental and psychological stress in the etiology of black hypertension. Except for the pilot study of the current investigators, there have been no published controlled studies of stress reduction programs for the treatment of hypertension in older blacks. We conducted a randomized, blinded, controlled pilot study of two classes of stress reduction techniques in the treatment of elderly blacks with mild hypertension in an inner city, community health center. Eighty elderly black male and female volunteers (mean age 66.8 yrs) with mild hypertension were randomly assigned to daily practice of Transcendental Meditation (TM), Progressive Muscle Relaxation (PMR), or to a diet and exercise group. After 3 months, the TM group showed BP reductions of 13.4/7.2 mmHg (p less than .OOOO1 for both SBP and DBP vs. controls), and the PMR group showed BP reductions of 4.8/2.3 mmHg (p less than .008 and less than .0005 vs. control, respectively). Controls increased 0.9/4.1 mmHg. The TM group decreases were significantly greater than for PMR on both SBP (p less than .004) and DBP (p less than .03). In contrast to typically low compliance rates of antihypertensive drug regimens, compliance with both stress reduction techniques exceeded 90%. Moreover, the TM group showed significant psychosocial changes in QL compared to controls, including enhanced personal efficacy (p less than .03) and reduced social isolation (P less than .015). Based on these pilot results, we propose to conduct a long-term, randomized, controlled, clinical trial of these two stress reduction techniques in the same community-based population of elderly blacks with mild hypertension. The 270 male and female subjects (aged 55-75 years) will be pretested over a 4 session baseline period on clinic BP, ambulatory BP, cardiovascular and emotional reactivity, and QL measures. Subjects will then be randomly assigned to either TM, PMR, or to a preventive cardiology counselling group. Subjects will be followed monthly with major posttests at 3 months and 18 months on these variables. If successful, this study will demonstrate the efficacy of new behavioral methods to reduce hypertension and improve quality of life and treatment compliance in this high-risk and underserved older minority population.